how do intakes of foods targeted for change relate to energy density? karen barton centre for public...
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How do Intakes of Foods Targeted for Change Relate to Energy Density?
Karen BartonCentre for Public Health Nutrition Research, University of Dundee
Wendy WriedenSchool of Pharmacy and Life Sciences, Robert Gordon University
Andrea SheriffDental Public Health, University of Glasgow
Background
Longstanding recognition of Scotland’s poor diet
Associated with high rates of chronic disease
Poor diet and health more likely with increasing deprivation
The Scottish Diet
Published by the Scottish Office Home and Health Department 1993
The Scottish Diet Action Plan
Scottish Dietary Targets (SDTs) set in 1996
Mixture of food and nutrient based targets
No target set for energy density
Energy Density
Energy density can be defined as the available energy in a standard weight of food
The regular consumption of energy dense foods has been linked to weight gain and obesity
In 2007, the World Cancer Research Fund (WCRF) set a population level energy density (ED) goal for diets of 125kcal/100g including milk but not other drinks
10 to 100kcals/100gNon starch vegetables, roots and tubers, and fruit
Low Energy Density
60 to 150kcals/100gCereals (grains) and pulses (legumes)
100 to 225 kcals/100gBread, lean meat, poultry and fish
Good source of desirablenutrients>225 to 275 kcals +/100g
Savoury>225 to 275 kcals+/100g
Sweet>225 to 275 kcals+/100g
High Energy Density
Fast Foods Readily available convenience foods- Energy dense- Consumed frequently- Large portions
1420 Kcal
Fast Foods
Obesity Route Map
In 2010, the Scottish Government highlighted the importance of consuming a less energy dense diet in the “Obesity Route Map” with an explicit commitment to support consumers to make more nutrient dense food choices
Aims
To use data from the Scottish sample of the UK Expenditure and Food Survey to estimate the energy density of the Scottish Diet
To examine food intakes by quintiles of energy density
To compare the results with the Scottish Dietary Targets (SDTs)
Scottish Dietary Targets
Target Food Scottish Dietary Target
Fruit and Vegetables More than 400g per day
Bread (all types) 154g per day
Brown/Wholemeal Bread More than 77g per day
Breakfast Cereals (all types) 34g per day
Oil Rich Fish 88g per week
White Fish No decrease (107g per week)
Expenditure and Food Survey (EFS) (now Living Costs and Food Survey)
Household purchase survey (conducted annually)
Average annual Scottish sample: 560 households and 1270 people
Collects information about household and eating out food and expenditure over 14 day period
Valuable source of information about food purchases of the population
Translated into estimates of the food consumption and nutrient intake
Can be used to calculate energy density and linked to indices of deprivation and diet cost
Methods (1)
Household food purchase data for Scotland from the UK Expenditure and Food Survey (EFS) were pooled from 2001-2008 and analysed to estimate energy density
Food and nutrient data obtained from UK Data Archive and ONSFoods grouped relevant to the SDTs
e.g. fruit and vegetablesHousehold foods and foods eaten outside the home combined to give total food intake per capita
Methods (2)
Adjustments made for fractions of composite foods, waste and any weight increase or loss due to cooking or dilution
ED was calculated for food and milk to reflect the definition used in setting the WCRF public health goal
Statistical analysis carried out using the complex samples component of SPSS Allows for survey sampling methods to be taken into account
Results are presented as population means with 95% confidence intervals (i.e. includes consumers and non-consumers) for household and eating out foods combined by quintiles of energy density
Results
The mean combined ED of the Scottish diet was 172kcal /100g The mean ED of households in the lowest quintile
was 123kcal /100g Comparable to the WCRF target (125kcal/100g)
The mean ED of households in the highest quintile was 231kcal /100g
Fruit & Vegetable Consumption
Lowest Highest
Bread Consumption
Lowest Highest
Breakfast Cereal Consumption
Lowest Highest
Oil Rich Fish Consumption
Lowest Highest
White Fish Consumption
Lowest Highest
Non SDT Foods Targeted for Reduction
In contrast consumption of cakes, sweet pies and pastries; confectionery, sugar containing soft drinks; red and processed meat was lowest in households within the lowest quintile of energy density
Conclusion (1)
Food purchase data from the EFS has successfully provided a means of estimating the ED for the Scottish diet
Average ED of the Scottish diet is considerably higher than the public health goal recommended by the WCRF
ED was not uniform across the population The analysis suggests that only a small
fraction of the population were able to achieve an ED close to the WCRF public health goal
Conclusion (2)
The diet of households within the lowest quintile of ED were closest to the food based dietary targets
These findings suggest that adherence to healthy eating advice can assist in reducing ED and may help prevent obesity
Acknowledgements
Project steering group FSA Scotland Scottish Government
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